Risperidone Overdose Management

Neurological Monitoring

• Akathisia and tremor may develop, presenting as motor restlessness, inability to sit still, and parkinsonian tremor, according to Praxis Medical Insights 1, 2
• Muscle rigidity and parkinsonism can occur, though less common in acute overdose, as reported by Praxis Medical Insights 1, 2

Cardiovascular Monitoring

• Orthostatic hypotension is common and requires serial blood pressure measurements in both supine and standing positions, as recommended by Praxis Medical Insights 1, 2
• QTc prolongation can occur but is typically minimal (0-5 ms mean increase), according to Praxis Medical Insights 1, 2

Metabolic and Laboratory Monitoring

• Complete blood count is essential to monitor for leukocytopenia, though this is more relevant to chronic use, as stated by Praxis Medical Insights 2, 3
• Liver function tests are necessary as transaminase elevations can occur, according to Praxis Medical Insights 1, 3

Symptomatic Treatment

• Lorazepam 1-2 mg IV/IM may be used for severe agitation if needed, as recommended by Praxis Medical Insights 3

Critical Pitfalls to Avoid

• Do not discharge without ensuring resolution of orthostatic hypotension, as falls risk is significant, according to Praxis Medical Insights 2